My Child has Asthma: Now What?

What is asthma? Do I have it, or does my child have it? If my child has asthma, will his friends catch it? Is my child going to outgrow it? Can my child use asthma medicine when he is sick and stop when he is better? So many questions start to twirl in parents’ heads once they are told that their child has asthma. Many people have preconceived ideas (some true, others false) about this disease. I aim to answer your questions and clarify any misunderstandings regarding asthma.

Defining asthma

Asthma can be medically defined as recurrent episodes of acute airway obstruction, increased mucus production and airway edema (swelling). What does that mean? Well, it means this is a disease that can happen again and again if it is not managed well. It makes the airways inside the lungs (bronchioles) smaller. These tubes get clogged by swollen airway lining and phlegm (airway mucus). These three elements are the hallmarks of asthma: airway narrowing, airway edema (swelling) and airway mucus (phlegm).

What causes asthma?

No one really knows exactly how asthma develops. There are many theories and possible explanations. We know asthma runs in families and more than 15 genes have been linked to the condition, so there is a genetic component to asthma. A family history of asthma increases the risk for a child to develop asthma. Other contributing factors are the environment and viral infections. Several epidemiologic studies document a link between air pollution and increased incidence of asthma. Respiratory syncytial virus (RSV) had been associated with increased airway sensitivity and possible progression to asthma (25% of children with an RSV infection develop asthma).

Is asthma common?

Incidence of asthma has been increasing yearly. In some reports, asthma afflicts up to 5% of children, while other estimates are as high as 12-15%. Many children develop asthma before the age of 6. Luckily, only a small percentage of these children continue to suffer from asthma when they become adults. The presence of other allergies (e.g., atopic dermatitis, food allergies, allergic rhinitis) will increase the risk for asthma persisting asthma into adulthood.

How do I know whether my child has asthma?

Children with asthma experience respiratory symptoms, such as shortness of breath, breathing difficulties, frequent coughing (especially at night), exercise intolerance, wheezing and recurrent pneumonia. The occurrence of any one of these symptoms should prompt you to seek medical attention. A family history of asthma, presence of other allergic conditions, presence of pets in the home, or living in a highly polluted environment increases the chances that the child’s respiratory symptoms are caused by asthma.

What treatment should we seek?

There are several medications that are used to treat asthma. One category relaxes the bronchioles; these drugs are called bronchodilators. Albuterol, a main ingredient in many inhalers, is a common bronchodilator. These drugs are usually nebulized (sprayed as a fine mist) by an air powered nebulizer or a puffer with a spacer and mask. Another group of medications targets the inflammation and mucus production in the airway. These medications are usually steroids, given by inhalation, orally or intravenously. A third group of medications targets the allergic responses. These drugs do not treat the acute symptoms of asthma, such as wheezing and shortness of breath. Rather, they stabilize the cells that are responsible for releasing chemicals that trigger many asthma symptoms. When these cells are stabilized, they do not produce allergy-causing chemicals, thus decreasing the frequency and severity of the asthma symptoms.

What is the long-term outcome?

Currently, we have many medications that control asthma. Complying with the treatment regimen and monitoring lung function closely can help the child to live a happy and productive life. Being asthmatic does not have to restrict the child’s physical activities. Many athletes who compete at the international level have asthma. Janet Evans, a famous Olympic swimmer who won many gold medals and set many world records, has asthma. Asthma did not influence her competitiveness – and it does not have to slow your child down either.